An umbilicus system for delivering medical services to mobile treatment platforms is described in our grandparent application, now U.S. Pat. No. 5,755,479. The disclosed umbilicus system establishes a useful, coordinated means of connecting highly capable mobile treatment platforms to a mother vehicle or other mobile source of supply containing medical and support utilities necessary to conduct surgery or perform a wide range of other medical procedures on the treatment platforms.
Prior to the development of a Rapid Deployment Hospital Module (RDHM) described in U.S. Pat. No. 5,236,390 to the second named inventor herein and which is hereby incorporated by reference, mobile hospital unit designs generally replicated existing hospital wall utility configurations and bed and gurney treatment platforms. The wall-only utility configurations of both mobile and fixed hospital units require the extension of multiple medical service lines to the gurneys, exposing the lines to disconnection and limiting access to the patient. Much time and attention are required to connect and disconnect the lines whenever the patient is relocated within or between treatment facilities. Typically, the lines and any mobile services or connections are hand carried, thrown atop the patient surface, or trundled alongside--all of which compromise stop-and-treat capabilities en route. Some services may be missing, and others are not organized to treat en route.
Other treatment discontinuities are precipitated by patient transfers between limited capability or overly specialized platforms, such as between beds, transports, and surgery tables. Typically, these patient platforms waste valuable space within their undercarriages and along their peripheries, requiring patient transfers to support even routine treatment and transport capabilities. The required patient transfers also result in unnecessary duplication of patient platforms and frequent breaks in treatment continuity.
Space, time, and resource limitations in the field provided us with the initial impetus to conceive of a treatment platform that would be modifiable and interchangeable among the RDHM's eight service junctions. By integrating those characteristics common to all hospital patient support devices into a common gurney, we designed a modular, multiple purpose platform capable of serving as emergency/reception, pre-op, surgery, post-op, intensive care, or many other specialties. Each gurney could be quickly configured to a required role and later modified to meet changing demands, optimizing capabilities of medical personnel and providing the focus for organization of the entire medical response.
Our umbilicus system, which bundles utility lines together for single point plug-in capability, opens a complete 360 degree access to the patient when connected overhead. Used in conjunction with onboard utilities, patients served by the umbilicus system are never disconnected from life-sustaining equipment and utilities. The umbilicus distributes utilities, which can include medical gases, electrical power, and communications directly to the gurney's medical equipment, supplanting the onboard utilities which are used for short transport intervals.
While further developing the umbilicus system, we recognized that a common mobile treatment platform could significantly improve patient management within a fixed facility as well. Patients in medical centers are, of necessity, moved from point to point nearly as much as in field settings. One typical example is hospital bed to pre-op to anesthesia to surgery to post-op/recovery to intensive care to hospital bed. Our common treatment platform with umbilicus system can be more flexibly and responsibly deployed throughout medical centers, transforming any predesigned utility service junction into a comprehensive treatment site, as patient flow circumstances dictate. Treatment teams can perform reliably at any bedside, when necessary, and in the meantime be assured that the logistics for monitoring and treating throughout the facility are optimized through commonality and modularity.
The central characteristic of our umbilicus/treatment platform system is a continuous treatment capability. In the field, critically injured patients suffer discontinuity of monitoring and treatment during transport and transfer from gurney to gurney. Vital procedures such as CPR and anesthesia require continuity of utilities, support equipment, and treatment surface during movement. Our gurney/umbilicus system reduces the negative effects of transport, rendering all umbilicus connection points en route common to one another, dependent only upon what additional equipment, specialized personnel, and telemedical data and consultation are available. Thus, the patient can remain with a single platform throughout his tour to and through a care facility as well as between facilities, whether fixed or mobile, and remain assured of prompt, sophisticated attention as needed.
A patient located on a single continuous care mobile treatment platform can travel onboard a modularly assembled unit through the spectrum of care within a fixed medical center. An on-board computer system can contain a complete, constantly updated medical record of the patient, available for review via a monitor located behind the patient's head or at alternate points on the platform. Specific medical and electrical equipment such as respirators, anesthetic machines, suction devices, EKG/defibrillators, blood/fluid infusion modules, and temporary electrical power sources (batteries and chargers) can be located immediately beneath a patient treatment surface. Various medical supplies and the equipment for producing or regulating the supplies can also be located in the space immediately below the treatment surface. These supplies include oxygen, anesthetic gas (N.sub.2 O), suction, air, and water. Additional equipment can be clamped to side rails.
An onboard valve system selects medical utilities from its onboard supplies or from the umbilicus service junction; such utilities include: the various medical supplies (oxygen, anesthetic gas, air, suction, and water) and electrical power (onboard battery vs. 120 volt AC electric through the umbilicus). The umbilicus can also provide a medical computer/telemedicine link between the onboard computer and offboard computers or other remote telecommunication devices. The utilities are preferably dispensed and monitored from a common service junction located along the platform head. The umbilicus service junction is preferably located at the platform foot to be least obtrusive to patient care activities which predominate at the patient's head area and along both sides of the patient's torso. Also, an extension of the umbilicus from the platform foot to similar access ports located on a ceiling further optimizes patient access by allowing a full circulation of 360 degrees around the patient with greatly reduced risk of any interference with the umbilicus.
Logistic benefits of a common, continuous treatment umbilicus/platform system include greater sharing of medical equipment among medical departments; more accurate, continuous and responsive monitoring of patients whatever their location in the facility; and fewer duplications such as "transport only" gurneys in hallways. Advances in digitization of medical data and in telemedical communication also support the appropriateness of the gurney/umbilicus as the prime focal point of data management, treatment, and monitoring efforts by the health care team. Computer storage of medical records already permits the physician and nurse considerable bedside information as in the examples of computerized Intensive Care EKG records and the military MARC Card and Meditag systems. Full development of this trend, including rapid bedside assay of vital signs, blood, urinalysis, and review of other diagnostic parameters such as digitized x-rays, MRI, and ultrasound images is certain to follow. A precise, quick, and comprehensive medical response requires a platform capable of managing data and providing medical support anywhere the patient is located.
An example of our medical treatment platform includes a main body supporting a treatment surface, onboard medically related utilities, and first and second service junctions. The first service junction includes an array of ports for delivering physiologic services to a patient supported on the treatment surface. The second service junction includes an array of ports grouped together and surrounded by an interlock for detachably securing an umbilicus containing a bundle of lines that convey medically related utilities from an offboard location.
The onboard medically related utilities can include medical supplies, such as medical gases, and a temporary electrical power source. The umbilicus can be arranged to deliver a more sustainable supply of the medical gases and electrical power through the second service junction. Onboard medical equipment, which is preferably modular in nature, can also be supported by the main body; and electrical lines can be used to connect the onboard medical equipment to both the onboard temporary electrical power source and the second service junction.
Supply lines connect the first service junction to both the onboard medical supplies and the second service junction. A switching system alternates delivery of the medical services to the first service junction between the onboard medical supplies and the offboard medical supplies distributed through the second service junction. An onboard controller related to the switching system can be used to regulate delivery of physiologic services through the first service junction to the patient. The controller is preferably related to an onboard computer that monitors operation of the switching system and the onboard equipment; maintains patient records; and governs data handling, analysis, patient status with trending, alarms, and communications. Communication lines within the umbilicus support similar functions from remote locations.
The main body can be divided into a central portion supporting the onboard medically related utilities and head and foot ends relating to the intended orientation of patients. The first service junction is preferably located together with a computer monitor at the head end, and the second service junction is preferably located at the foot end. A group of replaceable service lines are bundled together and connected to the first service junction for delivering a plurality of the physiologic services to patients. The bundling facilitates monitoring of the lines, reduces risk of inadvertent disconnection, and provides for rapid replacement of all the service lines in advance of treating a different patient.
The umbilicus preferably includes a sheath enclosing a bundle of lines which provide all the medical utilities necessary to perform medical and surgical procedures including: various medical gases, suction, air pressure, water, electric power, and medical monitoring/computer system/telemedical communications. The sheath can be reinforced, or a metal safety cable can be included among the bundled lines and connected to a nearby support to protect the other lines from overextension. The umbilicus can be any appropriate length, for example from five to fifteen feet, and can be permanently fixed to either a common supply source or the treatment platform, but is preferably separately attachable to and detachable from both. Standardized service junctions connected to sources of medical utilities and electrical/communications can be located anywhere appropriate, such as in mobile units including helicopters, transport aircraft, ships, or ground vehicles or in fixed facilities such as clinics, hospitals, and medical centers.
An example of our system for delivering medically related utilities to a treatment platform from a plurality of different sites includes a treatment platform having an onboard service junction with an array of ports grouped together for receiving a plurality of medically related utilities. Offboard service junctions, which are located at a number of different sites and are connected to a supply of the medically related utilities, include arrays of ports grouped together for delivering the medically related utilities. At least one umbilicus is used to alternately connect the onboard service junction of the treatment platform to different offboard service junctions. Each umbilicus contains a bundle of lines for conveying the medically related utilities and has a first head end that is engageable with the offboard service junctions for receiving the medically related utilities and a second head end that is engageable with the onboard service junction of the treatment platform for delivering the medically related utilities to the treatment platform. At least one of the first and second head ends is disengageable from one of the service junctions and engageable with another of the service junctions for supplying the same medically related utilities to the treatment platform from more than one site.
For example, the first head end of the umbilicus can be disengaged from the offboard service junction at one site and engaged with the offboard service junction at another site. Alternatively, the second head end of a first umbilicus can be disengaged from the onboard service junction of the treatment platform at one site, and the second head end of a second umbilicus can be engaged with the onboard service junction of the treatment platform at another site.
Preferably, the ports of both the onboard service junctions and the offboard service junctions are each grouped together and surrounded by an interlock. The head ends of the umbilicus engage the interlocks for simultaneously connecting the groups of ports with opposite ends of the bundle of lines within the umbilicus. The umbilicus preferably contains separate lines for conveying medical gases, electrical power, and communications. The offboard service junctions can be located in a common fixed facility, in different facilities, or in mobile transports to or from the facilities. Regardless of location, the offboard service junctions are preferably standardized so that the first head end of the umbilicus is engageable with all of the standardized offboard service junctions.
The system provides the capability to move patients virtually anywhere on a single treatment platform under continuous care and monitoring, whether the supplies and energy resources for providing the care originate from offboard standardized service junctions or onboard sources. The onboard supplies also provide a back-up during power outages and significantly increase the flexibility of fixed or mobile facilities to respond to rapid influxes of patients. Also, the ability to accommodate medical or surgical procedures at any location of the standardized offboard service junctions speeds the delivery of appropriate care and adds more flexibility to treatment locations. Awkward patient transfers between treatment platforms and between treatment locations are reduced. Locating a complete medical history with the patient at all times including times between treatment locations also contributes to the delivery of appropriate medical care any time as needed.